Availability

Adults: As sole diuretic, initially 100 mg/day P.O. (range of 25 to 200 mg) in single or divided doses, continued for 5 or more days and then adjusted to optimal therapeutic level

Children: 1 to 3 mg/kg/day P.O. as a single dose or in divided doses

➣ Essential hypertension

Adults: Initially, 50 to 100 mg/day P.O. as a single dose or in divided doses, continued for at least 2 weeks

Children: 1 to 2 mg/kg P.O. b.i.d.

➣ Hypokalemia

Adults: 25 to 100 mg/day P.O.

➣ Diagnosis and treatment of primary hyperaldosteronism

Adults: For diagnosis, 400 mg/day P.O. for 4 days in short test or for 3 to 4 weeks in long test. Resolution of hypokalemia and hypertension confirm diagnosis of primary hyperaldosteronism. Dosages of 100 to 400 mg/day P.O. may be used as a bridge to surgical therapy; in patients unsuitable for this therapy, lowest effective dosage may be used for long-term maintenance.

Patient teaching

• Tell patient to take daily dose with breakfast. If two daily doses are prescribed, advise him to take second dose with food in mid-afternoon.• Advise patient to restrict intake of high-potassium foods and to avoid licorice and salt substitutes containing potassium.• Tell male patient drug may cause breast enlargement.• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and herbs mentioned above.

spi·ro·no·lac·tone

(spī'rō-nō-lak'tōn),

A diuretic agent that blocks the renal tubular actions of aldosterone. It increases the urinary excretion of sodium and chloride, decreases the excretion of potassium and ammonium, and reduces the titratable acidity of the urine; most effectively used to potentiate the natriuretic action and reduce the potassium excretion produced by other diuretics.

spironolactone

/spir·o·no·lac·tone/ (spi″rah-no-lak´tōn) one of the spirolactones, an aldosterone inhibitor that blocks the aldosterone-dependent exchange of sodium and potassium in the distal tubule, thus increasing excretion of sodium and water and decreasing excretion of potassium; used in the treatment of edema, hypokalemia, primary aldosteronism, and hypertension.

spironolactone

(spī′rə-nō-lăk′tōn, spī-rō′-, spī-rŏn′ə-)

n.

An aldosterone antagonist and antiandrogen, C24H32O4S, that promotes diuresis and is used to treat fluid retention, androgenic syndromes in women, and hypertension.

spironolactone

[spī′rənəlak′tōn]

a potassium-sparing aldosterone antagonist diuretic.

indications It is prescribed in the treatment of primary hyperaldosteronism, edema of congestive heart failure, cirrhosis of the liver accompanied by edema, nephrotic syndrome, essential hypertension, and hypokalemia.

Increased myocardial depressionIncreased risk of ventricular arrhythmias if lidocaine is given with quinpristin/dalfopristinIncreased risk of ventricular arrhythmias if lidocaine is given with any drug that prolongs the QT interval of the cardiac cyclePlasma concentration of lidocaine increased by amprenavir, atazanavir and lopinavirIncreased myocardial depressionIncreased risk of lidocaine toxicity when given with propranololThe action of lidocaine is antagonized by the hypokalaemia caused by acetazolamide, loop diuretics or thiazide and related diuretics (i.e. a greater dose of lidocaine would be required to achieve anaesthesia)Increased risk of ventricular arrhythmia if lidocaine is given with dolasetronPlasma concentration of lidocaine increased when given with cimetidine; risk of lidocaine toxicity increased with cimetidine

BupivacaineMarcainLevo-bupivacaineChirocaine

Beta-blockers

Increased risk of bupivacaine toxicity when given with propranololIncreased risk of myocardial depression if given with other antiarrhythmic agents

PrilocaineCitanest

Antiarrhythmic agentsAntibacterial agents

Increased risk of myocardial depression if given with antiarrhythmic agentsIncreased risk of methaemoglobinaemia if given with sulphonamide antibacterial agents

RopivacaineNaropin

Antidepressants

Metabolism of ropivacaine is inhibited by fluvoxamine, thereby enhancing the risk of ropivacaine toxicity

MepivacaineScandonest

Drug not listed in the British National Formulary

spi·ro·no·lac·tone

(spī'rō-nō-lak'tōn)

A diuretic agent that blocks the renal tubular actions of aldosterone.

spironolactone (spī´rənōlak´tōn),

n brand names: Aldactone, Spirozide; drug class: potassium-sparing diuretic; action: competes with aldosterone at receptor sites in distal tubule, resulting in excretion of sodium chloride and water and retention of potassium and phosphate; uses: treatment for edema, hypertension, diuretic-induced hypokalemia, and cirrhosis of the liver with ascites.

spironolactone

a competitive antagonist of aldosterone, used as a diuretic. It increases resorption of sodium in the distal renal tubules.

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